Healthcare Provider Details

I. General information

NPI: 1841752607
Provider Name (Legal Business Name): VINEETH SUDHINDRAN MBBS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 BAYSHORE BLVD
TAMPA FL
33606-2707
US

IV. Provider business mailing address

PO BOX 1289
TAMPA FL
33601-1289
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-5544
  • Fax:
Mailing address:
  • Phone: 813-844-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberME169607
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number69240
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number30290
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: